Misuzu Yahaba1, Naoko Kawata2, Ken Iesato3, Yukiko Matsuura4, Toshihiko Sugiura5, Hajime Kasai6, Yoriko Sakurai7, Jiro Terada8, Seiichiro Sakao9, Yuji Tada10, Nobuhiro Tanabe11, Koichiro Tatsumi12. 1. Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan. Electronic address: mis_misuzu@yahoo.co.jp. 2. Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan. Electronic address: chumito_03@yahoo.co.jp. 3. Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan. Electronic address: iesato_k@yahoo.co.jp. 4. Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan. Electronic address: matsuyuki_future@yahoo.co.jp. 5. Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan. Electronic address: sugiura@js3.so-net.ne.jp. 6. Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan. Electronic address: daikasai6075@yahoo.co.jp. 7. Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan. Electronic address: yoliri@nifty.com. 8. Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan. Electronic address: jirotera@chiba-u.jp. 9. Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan. Electronic address: sakao@faculty.chiba-u.jp. 10. Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan. Electronic address: ytada@faculty.chiba-u.jp. 11. Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan. Electronic address: ntanabe@faculty.chiba-u.jp. 12. Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan. Electronic address: tatsumi@faculty.chiba-u.jp.
Abstract
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation caused by emphysema and small airway narrowing. Quantitative evaluation of airway dimensions by multi-detector computed tomography (MDCT) has revealed a correlation between airway dimension and airflow limitation. However, the effect of emphysema on this correlation is unclear. OBJECTIVE: The goal of this study was to determine whether emphysematous changes alter the relationships between airflow limitation and airway dimensions as measured by inspiratory and expiratory MDCT. METHODS: Ninety-one subjects underwent inspiratory and expiratory MDCT. Images were evaluated for mean airway luminal area (Ai), wall area percentage (WA%) from the third to the fifth generation of three bronchi (B1, B5, B8) in the right lung, and low attenuation volume percent (LAV%). Correlations between each airway index and airflow limitation were determined for each patient and compared between patients with and without evidence of emphysema. RESULTS: In patients without emphysema, Ai and WA% from both the inspiratory and expiratory scans were significantly correlated with FEV1. No correlation was detected in patients with emphysema. In addition, emphysematous COPD patients with GOLD stage 1 or 2 disease had significantly lower changes in B8 Ai than non-emphysematous patients. CONCLUSIONS: A significant correlation exists between airway parameters and FEV1 in patients without emphysema. Emphysema may influence airway dimensions even in patients with mild to moderate COPD.
BACKGROUND:Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation caused by emphysema and small airway narrowing. Quantitative evaluation of airway dimensions by multi-detector computed tomography (MDCT) has revealed a correlation between airway dimension and airflow limitation. However, the effect of emphysema on this correlation is unclear. OBJECTIVE: The goal of this study was to determine whether emphysematous changes alter the relationships between airflow limitation and airway dimensions as measured by inspiratory and expiratory MDCT. METHODS: Ninety-one subjects underwent inspiratory and expiratory MDCT. Images were evaluated for mean airway luminal area (Ai), wall area percentage (WA%) from the third to the fifth generation of three bronchi (B1, B5, B8) in the right lung, and low attenuation volume percent (LAV%). Correlations between each airway index and airflow limitation were determined for each patient and compared between patients with and without evidence of emphysema. RESULTS: In patients without emphysema, Ai and WA% from both the inspiratory and expiratory scans were significantly correlated with FEV1. No correlation was detected in patients with emphysema. In addition, emphysematous COPDpatients with GOLD stage 1 or 2 disease had significantly lower changes in B8 Ai than non-emphysematous patients. CONCLUSIONS: A significant correlation exists between airway parameters and FEV1 in patients without emphysema. Emphysema may influence airway dimensions even in patients with mild to moderate COPD.
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Authors: Marcelo Cardoso Barros; Bruno Hochhegger; Stephan Altmayer; Guilherme Watte; Matheus Zanon; Ana Paula Sartori; Daniela Cavalet Blanco; Gabriel Sartori Pacini; Jose Miguel Chatkin Journal: PLoS One Date: 2018-10-11 Impact factor: 3.240